母血、羊水、脐血中细胞因子含量变化与胎膜早破、宫内感染及新生儿预后的关系

The relationship between cytokine levels in maternal serum,amniotic fluid,umbilical cord serum and premature rupture of membranes,intrauterine infection and prognosis of neonates

目的:探讨母血、羊水、脐血中3种细胞因子白细胞介素-6、8(interleukin-6、8,IL-6、8)、血管细胞粘附分子-1(vascular cell adhesion molecule,VCAM-1)对胎膜早破、绒毛膜羊膜炎和判断新生儿预后的临床意义。方法:采用双抗体夹心酶联免疫吸附法检测58例胎膜早破及38例正常孕妇(对照组)母血、羊水、脐血中IL-6、IL-8、VCAM-1水平的动态变化,同时进行胎膜的病理检查。结果:胎膜早破组母血、羊水、脐血中IL-6、IL-8、VCAM-1的含量均高于对照组,其含量随破膜时间的延长而增高,尤其破膜时间超过24h增高更为明显。绒毛膜羊膜炎患者母血、羊水、脐血中IL-6、IL-8、VCAM-1水平明显高于非绒毛膜羊膜炎患者,差异具有显著意义(P<0.05,P<0.01),胎膜早破组产妇所生新生儿Apgar评分≤7分者,其母血、羊水、脐血中IL-6、IL-8、VCAM-1的含量显著高于Apgar>7分的新生儿(P<0.05,P<0.01)。结论:IL-6、IL-8、VCAM-13种细胞因子联合检测可用于胎膜早破并绒毛膜羊膜炎早期诊断,对判断新生儿预后也具有一定的临床价值。

Objective： To explore the relationship between cytokines levels of IL - 6, IL - 8 and vascular cell adhesion molecule - 1 （ VCAM - 1 ） in maternal serum, amniotic fluid and umbilical cord plasma of women with premature rupture of membranes, chorioamnionitis and predict prognosis of neonates. Methods： The levels of IL - 6, IL - 8 and VCAM - 1 in maternal serum, amniotic fluid, umbilical cord serum were detected by enzyme linked immunosorbent assay in 58 pregnant women with premature rupture of membranes and 38 women with normal pregnancy （control group） . Results： The levels of IL- 6, IL- 8 and vCAM -1 in premature rupture of membranes group were significantly higher than those in control group （P 〈 0. 05, P 〈 0. 01 ）. The longer the duration from rupture of membrance to delivery was, the more serious chorioanmionitis was, and the higher the levels of IL - 6, IL - 8 and VCAM - 1 were. The levels of IL - 6, IL - 8 and VCAM - 1 in women with chorioamnionitis were significantly higher than those without chorioamnionitis （ P 〈 0. 05, P 〈 0.01 ）. The levels of IL-6, IL-8 and VCAM - 1 were significantly higher in neonates whose Apgar score≤7 than those in neonates whose Apgar score≥ 8. Conclusion： Measurement of IL - 6, IL - 8 and VCAM - 1 levels in maternal serum, amniotic fluid, umbilical cord serum is an useful biomarker for identifying chorioamnionitis and predicting premature rupture of membranes.